Provider Demographics
NPI:1790175156
Name:OASIS HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:OASIS HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANI
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-540-7202
Mailing Address - Street 1:2414 S. FAIRVIEW ST., #105
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5318
Mailing Address - Country:US
Mailing Address - Phone:714-540-7202
Mailing Address - Fax:714-540-5941
Practice Address - Street 1:2414 S FAIRVIEW ST STE 105
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-5318
Practice Address - Country:US
Practice Address - Phone:714-540-7202
Practice Address - Fax:714-540-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43101207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty